HomeMy WebLinkAboutBrophy, Frank JUDITH T. TERRY :, • Town Hall, 53095 Main Road
TOWN CLERK : o T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �� Southold, New York 11971
MARRIAGE OFFICERtin
�'. O�'3, Fax (516) 765-182365-1
RECORDS MANAGEMENT OFFICER - * `��0'1 Telephone (516) 765 1801
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1116 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS - NOT CLOSER THAN
EXISTING DISTANCES FROM WELLS, PROPERTY LINES, BUILDINGS.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner BROPHY, FRANK
Mailing Address 1 P. O. BOX 271
City St Zip NEW SUFFOLK NY 11956
Property Address 1 75 SECOND STREET
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 10 lot 20.007
Cross Street JACKSON STREET
Building Permit Number Cross Reference:
Issue Date: 4/20/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL
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JUDITH T. TERRY ` : Town Hall, 53095 Main Road
TOWN CLERK ; o r=7, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER Q Nr ��` Fax (516) 765 1823
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•� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: &fZ / / ' '
Transmitted herewith is a copy of application No. /9 j /5 7 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
tf-Y-1-67J2-4.- 0,--/CJ-4/242_4„Cig,,L.,) AC do,2 / /
Please review the application and location map and advi illir this office may
issue the permit.
Please complete the form below and return it to this office.
Thank you. 44,
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - i .'
DISAPPROVE - ellaIMON Wpm"
COMMENTS: :f ..2l
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49.11 "g/zAllib.1‘ 6Y-1 a4 0104 -
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Signature '
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Date
A
OF„jICE .OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk ;' �� ��/ Application Noft
'Town Hall, 53095 Main Road Construction
P. O. Box 1179 1-71
Southold, New York 11971 ;tctm • Alteration
= ,yy ���,' $10.00 -Residential
Telephone
(516) 765-1801 = Ol �, !' $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ q
DATE // /f9Y
APPLICANT NAME: fia,Qr.S
APPLICANT ADDRESS: 0/‘D y .4/4/ T(orr
SEPTIC CESSPOOL
DESCRIPTION OF//1 CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: p Pfy
OWNER MAILING ADDRESS: D ��K `
e.3 lfz /7 Y
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section ll 7 Block 76 Lot Z 7
CROSS STREET: e2Clf ,f1 S'
BUILDING PERMIT NUMBER CROSS REFERENCE:
Ade,
/ Signature of Applicant
RECEIVED BY: V— /
Town Clerk's Office
DATE:
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